the myoclonic jerk

turning rebellion into money

Thursday, May 19, 2005

all over the place

wow, just like that, i'm an MS2. pretty fuckin' sweet.

at least i think i am now. that all depends on whether i passed the musculoskeletal exam. now i know exactly how it feels to wish i had studied more. i've been a good little gunner for almost a year, but i flamed out as i am wont to do, just like old times!

i have a clinical skills exam tomorrow morning, but it's just a timed H&P on a standardized patient. easy peasy lemon squeezy! then off to`new york. all day i've been repeating a line i remember from wayne's world, back when it was just on SNL. "i'm from new york. i've got a gun. let's go to a broadway show!".

enough with the silliness. cut to cure had a post a couple weeks back about the future of trauma surgery. there's a deep part of my brain that says "trauma surgery! i'm fucking so on that shit!", but it gets beaten down by the more realistic part of me that says "nah, it's the expressway to a divorce.." since i had to bribe and cajole the husband to stay with me while i'm in school (not really, but he did get some nice dinners right before i started), i'm interested in doing anything i can to make sure i don't turn out to be just another divorced surgeon.

but that's not really what i wanted to write about. he mentioned generation X, generation Y and (of all things) generation Z, which is such a stupid fucking name. so i'm wondering, what is X vs. Y in terms of years included?

in high school, i worked in a coffee house largely staffed by zine-reading, whippets-inhaling, psychology-degree-having 25-year-olds. they had dreads and listened to seven year bitch, drove banged up late 1960s comets and dusters and were the coolest people i could imagine. they were letter perfect to how the media portrays generation X. i was crushed because i figured i was in this other, shittier generation, who was known mainly for being spoiled, bipolar and liking limp bizkit. i just wanted to be like christian and kelly and a girl named toast, who was a drummer and was in three bands at once!

when i got to be around 25, the memory of these terminally hip people was replaced by the reality that they must be in their mid-thirties now, and how uncool it really was to have so little to show for your age. i thought maybe it was better to be in gen Y- at least i had more time to have fun and popular culture hadn't quite whittled us down into a 2 minute alternative rock montage of hairstyles. now i'm not sure where i want to be. it seems both generations are considered together when it comes to discourse on the current direction of medical specialties, and i'll get the same result no matter what label i stick on my white coat.

it's kind of a letdown that generations X and Y as discrete entities is a myth, and that one really has to determine which generation they fit into better. being born on the cusp of two astrological signs, i guess i can sorta understand. just like i'm totally more gemini than taurus, i think i'm more X then Y. and just like astrological signs, it's nothing more than entertainment in the end.

Wednesday, May 18, 2005

just alterations

today i got some pants back that i had gotten altered. i'm annoyed that i even had to do this, because it is a new thing for me. maybe it's that i'm suddenly buying "slacks" for clinical wear, or Maybe it's that the american fashion industry is on some terribly entertaining drug. all the sudden all the fucking pants i buy are so long i can't even wear them.

i'm not short by any means- in fact, i'm an 1 1/2" taller than the average american woman. so how come all nice pants these days have 35" inseams? my dad, who is 6'2", doesn't even have a 35" inseam. wtf?

i took them to a place called "just alterations". the girl there irks me. she's not even remotely friendly, but not outright rude either. she's just there. no inflections in her voice, no "hi! how are you?", no smile, nothing. it's not like she's old or freaky or anything. she's my age, and a cute girl! why is she bitter? maybe she hates everything in life except viscose. i tried smiling at her, making small talk. nothing worked. she was even a bit snarky in asking me exactly how i wanted them when she was measuring the hems. i guess i didn't give her the right answer, but shit, i'm not a tailor- so how am i supposed to know the ins and outs of of pant shortening? i wouldn't get pissed at you for not knowing exactly what i do in my job (actually, i think i'll prefer it thanks). i thought maybe she was having a bad day or two last week, and today she might be different, right? wrong, still the personality of the wire hanger my pants were on. i guess that's why the place is called "just alterations" and not "alterations with a smile".

and while i'm bitching about stupid shit, why doesn't the washington DC area have a well fargo? it's really my fault for picking a bank based on their extensive use of stagecoach logos. and what do you say when people ask you what state washington DC is? i always say "it's a district. of columbia". i don't even think it has a state. it's stateless, just like how the 5 boroughs in new york city are like counties within a city, but also in another county. this east coast shit is whack, yo.

A cuckold is, quite simply, a man with an unfaithful wife. There are connotations of helplessness and humiliation attributed to the word, implications that the husband is helpless to stop her infidelity, and too cowardly to leave the wife. "Cuckold" appears in older texts as a highly insulting and pejorative term.

Cuckolds are sometimes written of as "wearing the horns of a cuckold" or just "wearing the horns". This goes back to an unsubstantiated reference to a tradition in villages of unknown European location where the community gathers to collectively humiliate a man whose wife gives birth to a child recognizably not his own. This is said to have been a parade where the hapless husband is forced to wear antlers on his head as a symbol of his wifes infidelity. Whether this actually happened or not is irrelevant to the phrase, which survived.

The history of the word is thought to be related to the Cuckoo bird, who is known to put its eggs in another bird's nest. Some think that this points to another hallmark of the cuckold  the raising of a child that is not his own.

Today the term is making a resurgence amongst non-monogamous couples with a dominant female allowed to take on additional partners, and submissive male who is not.

my carpool buddy and i were discussing this word today. its etymology is especially interesting- those no-good whoring birds!

Sunday, May 15, 2005

a quandary: hang out with surgeons or your former high school classmates?

so i just found out this week that my 10 year high school reunion is coming up. there isn't a concrete date set yet, and as luck would have it, the first choice date is october 22. this is the same day as the start of the osteopathic surgical conference, which is in orlando. the reunion will be in LA.

as the national liaison for the SOSA chapter at our school, my only duty is to go to these conferences and schmooze. the surgical club at our school has sucked for the last couple of years, so we really need to get back into the national scene. i'm really hoping they pick another date for the reunion, so i can go.

i didn't think i'd care about my reunion, but it's like watching a car chase on live tv- i just gotta see if there's a crash (read: formerly cuter-than-shit girls with big fat asses and possibly alcoholic husbands).

i'm going to be overly dramatic right now and state that this is a conscious effort on behalf of the gods to fuck with my serenity. the extracurricular stuff i'm doing for the upcoming year was meticulously chosen for the fact that it wouldn't take up too much of my time. now my lone opportunity to help our school get it's surgical mojo back will deprive me of the immature pleasure i take in seeing how badly my classmates have aged. what are the fucking odds that the only two big things i should attend this year on are the same date?

dammit!

i was watching romy and michelle's high school reunion yesterday on the ABC family channel (shut up), and it struck me how much anxiety people tend to have about reunions. yesterday i went to indian buffet with some high school friends who i still hang out with, and we all made pacts to lie about what we really do. the thing is, i actually don't want people to know what i do because part of me is embarrassed to be where i am. it's partially because of my age- if i'd found my self-confidence earlier i'd be in my third year of residency by now. but mostly it's because i was sort of a fuck-up in high school. i got ok grades- some good, some bad. i dabbled in tons of clubs but wasn't serious about any of them. mostly i was the "kooky" girl, owing to my fashion sense, a big mouth and being in the drama troupe. my yearbooks are filled with "stay unique!" or "you're so crazy!". people seemed surprised that i was going to college at all, and always thought i would study art or theatre.

10 years later, i feel like it'll be anti-climactic to come as a happily married medical student. so, i'm gonna be a pirate.

i haven't decided yet whether i'm going to go through with the plan and have the "sea police" come into the reunion and handcuff me and take me away, but i do have some nice police issue handcuffs that should be put to use. shit, saying i run a savage band of murderers around the south china sea is highly preferable to saying i study the kidneys and lungs.

Saturday, May 14, 2005

xanax me, bitch!

i've been more than a little anxious lately:

-musculoskeletal final is next thursday. although i've done well in all my previous classes and definitely will not be forced to repeat next year, i still worry i'll tank the last class. and since it's a relatively easy subject, it would be fantastically embarrassing to fail it. it's been nearly a whole year in school (cuz i started anatomy early), and studying is really not happening at this point.

-my 28th birthday is in exactly one week. 30 is coming down the pipe, the floating deadline for not being a fuck-up in my mind. birthdays as days are either very good or really really bad. i'm hoping it's the former this year cuz i could use some good times right about now.

-flying to new york on friday. flying to DC on the 28th. i don't like flying. at all. it's not so much a "flaming sonic winged death" issue, more that i don't like being squeezed into a tiny seat for five hours with nowhere to go. that and the possibility of living long enough to know i'll die soon, smashing headfirst into the ground at 300 miles an hour. this is complicated by the fact that the people who sit next to me on planes are always 1) fat as fuck and 2) talkative as fuck. especially if they find out i have anything to do with the field of medicine. but i am hopeful! the mr. is coming with me, so between him, my favorite book and the ipod, i should be able to ward off any annoying rays.

-starting NIH fellowship. will i be smart enough? will i work hard enough? will i get published? will the cool kids snicker and shun me when i tell them i'm from a DO school? gotta learn that dance from can't buy me love stat.

Tuesday, May 10, 2005

that's dr. cannon-fodder to you

i had a classmate take the above with his cell. they're little squishy dolls from the air force, part of the constant recruiting efforts to get more indentured servants- i mean, medical service members into the military. those dolls did their job well- if their job was to distract us from lecture for hours on end as we "modified" them. some students built a scary clone army which valiantly defended the center right back row from the seat-stealing insurgents. it is our god-given right to sit in the seats we have become accustomed to, and to rain down like fire on any person that tries to take that liberty away from us.

so no doubt if anyone is reading this, i'll get some hate mail of some sort. as you might be able to tell, i'm not a fan of the military. they called me relentlessly after high school, offering me all sorts of booby prizes like "money for college" or "structure". i told them i had a real issue with waking up early and was described by my parents as "congenitally insubordinate", and told them to kindly fuck off. thankfully they did, until i started med school. now i get lovely letters from the navy all the time telling me how awesome it will be on a big fat fucking boat stuck somewhere in the persian gulf.

according to the bureau of labor statistics, there were 25,563 officers in the category of "health professions" in all branches of the armed forces in 2003. i really, really wonder how many of them wish they were somewhere else.

plenty of my classmates are on the flag-draped coffin scholarship, and will be spending this summer in officer basic, which they describe as "kinda like basic training, but way easier!". um, somehow i doubt that. but nonetheless, i don't hold anything against them for wanting to go military- on the surface, it promises job security, a good residency and it's free! the ones that have already served and are coming back for more (thinking of med school as an extended leave if anything) will be happy to be back in, and will make fantastic military docs. the others i worry about, many because they are doing it for the money. money is THE big issue, because most of us will come out into residency 200 grand in debt, and we make like 40 grand starting. so it makes sense that some people want to get a free ride.

it's a free ride alright. for uncle sam. he ponies up some cash and buys your well-educated ass. there's a year for year commitment required, which doesn't include school, internship, or residency. with all the stop-loss orders and creative data fudging going on, i wouldn't be surprised if some people end up career military docs because they just can't seem to get discharged. cuz remember: they own you.

they will tell you all sorts of lovely things to get you to join up. between repeating "we pay for medical school! we'll even give you some money!" over and over, they tell you you'll get the cush residency of your choice, then a nice appointment at a VA somewhere, where you can sit back and rake in the dough, knowing that those patients you treat can't sue you if something happens. it's the same old bullshit as what is being told to high school seniors everywhere. the world is promised to the potential recruit, a world of endless choices.

when you sign up, you discover these choices are all theirs.

you specialize in what they tell you to specialize in. wanna do derm? sorry, they have enough derms, but they need more IM docs. so, you get to do IM. want to live close to your family? sorry, you get to live where they tell you to live, be it north carolina or baghdad. don't want to die? sorry, if you are told to go mend severed limbs in an active combat zone, you go knowing you might be another blurb on the evening news, described as "name will not be released until family members have been notified". i wish i could find data on how many military physicians are ever in active combat areas. if anyone can provide this data, i'd be curious to see how often docs are put in direct danger. is your life worth 200 grand and a $1200 a month stipend?

i found a short article from a military doc detailing his views of the current problems with the system. he makes a good point, in that sometimes the free tuition doesn't add up when you factor getting to practice a specialty you want, the ever-present autonomy factor and a system of insulting pay and little ability to advance. it sounds like a shitty job, not a calling.

just so you know, i do see the irony in my above statements. medicine (surgery especially) is the same beast as military service when it comes to the structure. i know i will get my ass handed to me many times in the near future and for the most part i welcome it. but the difference i see in my future civilian career is that i can go into the specialty i want to go into, as long as i have the stats. i can leave it anytime i like, with crushing debt but my medical license intact. that's not what i'd get if i told the armed forces "sorry, you know this kinda sucks. i'm giving my two weeks as of today, cuz i think i'd be better off somewhere else".

there are other ways to get a free ride through med school than wearing camo. NHSC sounds like a fantastic deal, but they only want primary care docs. i guess poor people don't really need surgery that much. but there are other loan repayment programs sponsored by state agencies, which allow for a greater amount of autonomy, less threat of a horrible painful death at the hands of some asshole with a rocket launcher, and the ability to actually get out when you're supposed to. that to me seems much more inviting than signing away your life to someone who won't even acknowledge those two little wars going on "over there".

since i have always wanted to work at a county hospital serving the poor and indigent, i know i won't make piles of money once i graduate. money isn't a huge thing for me, but the freedom to choose how to practice medicine is. it's scary thinking of how many of my classmates will hold up their end of the bargain, sacrificing what they worked so hard to procure, only to be kicked in the nuts when they realize the military is only looking out for itself. it's their choice though, and i hope they thought long and hard before they signed those papers.